Cutting the wait times for medical procedures is one of 12 recommendations contained in the final report from Alberta’s queue-jumping inquiry.
Long waiting lists for medical care can prompt patients to look for ways to jump to the front of the line, said inquiry commissioner John Vertes.
In his final Health Services Preferential Access Inquiry report, the retired judge calls on the province to set up a comprehensive wait-time management measurement system.
Premier Alison Redford ordered the queue-jumping inquiry after a report by the Alberta Health Quality Council on problems with the province's $16-billion health-care system.
There was also controversy over comments made by the former head of Alberta Health Services, Stephen Duckett, who claimed preferential access to care was a common practice when he took over and politicians had fixers who could get valued constituents faster treatment.
Raj Sherman, an emergency room doctor and now Alberta Liberal leader, made similar allegations, adding doctors were intimidated into going along.
Cancer screening centre cited
The inquiry heard 68 witnesses and examined 172 exhibits in Calgary and Edmonton from fall 2012 to spring 2013.
Other recommendations include introducing a standardized referral booking system to improve access and cut down on the time it takes for patients to receive a referral in Alberta.
According to the final report, claims made by some people that it was common for rich, well-connected Albertans and politicians to jump wait lists for medical care proved to be unfounded. But the inquiry did discover other instances of queue-jumping, Vertes said.
Evidence showed the Forzani and MacPhail Colon Cancer Screening Centre in Calgary provided improper preferential access to patients from a private clinic.
Witnesses testified the centre gave preferential treatment to patients from the Helios Wellness Centre, a private clinic nearby on the University of Calgary campus that charges members $10,000 a year for health services.
Testimony suggested that between 2008 and 2012, Helios patients were treated within weeks or months — well ahead of the three-year wait other patients endured. Vertes found those concerns well-founded.
Calgary Flames also jumped queue
"For a significant period of time, some patients … received improper preferential access to CCSC screening colonoscopies," he wrote. "There was no medical or ethical justification for this preferential treatment."
The University of Calgary said in a statement it would not immediately comment on the findings.
Vertes also found that a special clinic set up to administer the H1N1 vaccine to members of the Calgary Flames NHL hockey team amid fears of a pandemic in 2009 was improper.
"The inquiry ... also identified several systemic issues that could foster an environment conducive to such improper access," Vertes said in his report.
Government health-care officials must fix the problem of queue-jumping in order to improve public confidence in the system, he said.
Vertes recommends clarifying the "scope and application" of professional courtesy, and providing guidelines to health-care practitioners. He also calls on the province to establish an independent office of health advocate to provide advice and advocacy for patients.
He also said it should be mandatory to report instances when patients are being pushed to the front of the line and added that whistleblowers should be protected.
Health Minister Fred Horne accepted the recommendations.
"Although Justice Vertes did find a few instances of improper preferential access, he was very clear that there was no evidence to support the idea that this was a widespread problem," he said, adding there was no sign of political interference.
Horne said a standardized referral system and health advocate are already in the works. The advocate's position is part of the new Health Act, which has been passed in the legislature but not yet proclaimed into law.
A separate inquiry has been called into the activities of Helios and the screening clinic.
Horne said it is expected to report soon.
Opposition weighs in
Opposition Wildrose Leader Danielle Smith applauded Vertes's recommendations on whistleblower protection for doctors. But she chastised the Redford government for not delivering the inquiry that it had promised.
She also praised Vertes for pointing out that long waiting lists contributed to the problem of queue-jumping in the first place.
Sherman said queue-jumping is just one symptom of a broken health-care system.
The provincial Liberal leader said the inquiry didn't uncover anything that wasn't known already and there were many areas that could have been explored more deeply, such as intimidation of front-line staff and why there is a queue in the first place.
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"This government has wasted precious time and millions of taxpayers’ money to investigate a symptom of a disease instead of formulating a plan to cure it," he said.
"Albertans deserve so much better than this. They deserve a government truly concerned about their health and well-being, not playing politics."
Dangers of privatization
New Democrat health critic David Eggen said the report shows the dangers of privatization in Alberta’s health-care system.
"All Albertans believe that they should have access to high-quality health care when they need it, regardless of their income," he said. "The fast-tracking for wealthy clients from these boutique private health clinics show the impact of two-tier health care, and confirm that you can’t trust this government to stand up for public health care."
Eggen said he would like to see the government strengthen laws that would ensure the system is fair for everyone.
Dr. Michael Giuffre, Alberta Medical Association president, said he is "generally pleased" with the report.
"I think the Alberta Medical Association would endorse the 12 recommendations that we saw," said Giuffre, who was attending the Canadian Medical Association annual convention in Calgary.
Giuffre said concerns about queue-jumping would fade away if lengthy wait lists were dealt with.
"People should be optimistic that we are actually trying to improve efficiencies and improve access," he said.
Interactive timeline of queue-jumping events: